Health Cluster Meeting UNFPA South Sudan Juba April 6 2016 1 Presentation Outline Types of RH Commodity Procurement Process Requisition AccessRH Challenges amp Way Forward Empirical Assumptions ID: 1032098
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1. Reproductive Health Commodity Security Updates Health Cluster MeetingUNFPA, South SudanJuba, April 6, 20161
2. Presentation OutlineTypes of RH CommodityProcurement ProcessRequisitionAccessRHChallenges & Way Forward
3. Empirical Assumptions…..Total Population3,018,700Persons# of women of reproductive age (WRA)755,000WRALive births per year121,000Births# of pregnancies that end in miscarriage or unsafe abortions per year that will require care 24,200Pregnancies# of currently pregnant women who will experience complications 18,100Pregnant women# of currently pregnant women who deliver who will need suturing of vaginal tears 9,000Pregnant women# of deliveries requiring a C-section 6, 000Deliveries# of maternal deaths averted in 12 months if MISP is fully implemented and all pregnant women have access to EmOC services3,000Deaths# of sexually active men who use condoms 120,000Men# of WRA who use modern contraceptives 35,500WRA# of cases of sexual violence (percent of WRA at risk of rape) 15,000WRA3
4. Contraceptives (UNFPA Supplies)4
5. UNFPA Supplies (2016)5
6. Inter-Agency ERH Kits6Block 1(Each kit is designed to provide for 10,000 people for 3 months )Block 2(Each kit is designed to provide for 30,000 people over a 3-month period)Block 3(Each kit is designed to provide for 150,000 persons for 3 months)Kit 1: Condoms (A and B) Kit 6: Clinical delivery assistance (A and B) Kit 11: Referral level kit for reproductive health (A and B) Kit 2: Clean delivery, individual (A and B) Kit 7: Intrauterine devices (IUDs) Kit 12: Blood transfusion kit Kit 3: Post rape treatment Kit 8: Management of miscarriage and complications of abortion Kit 4: Oral & injectable contraception Kit 9: Suture of tears (cervical and vaginal) and vaginal examination Kit 5: Treatment of STIs Kit 10: Vacuum extraction delivery Kit 0 – Administration/training supplies Dignity kits
7. Core Pipeline 20167Kit En route (A) National level (B) State level (C)Total (D = B + C)2016 Target (F)Gap(G=F-D-A )Unit Cost (US$)Total Gap(US$)Kit No.0 - 00000 124 - Kit No. 1A - 000 1,208 1,208 566 683,728 Kit No. 1B - 000 252 252 371 93,492 Kit No. 2A 50 122173295 604 259 641 166,019 Kit No. 2B 50 423072 - - 127 - Kit No. 3 50 77683 256 123 801 98,523 Kit No. 4 - 000 50 50 427 21,350 Kit No. 5 50 0198198 250 2 672 1,344 Kit No. 6A - 06060 518 458 478 218,924 Kit No. 6B 50 2800 - - 956 - Kit No. 7 - 000 30 30 253 7,590 Kit No. 8* 42 04747 403 314 573 179,922 Kit No. 9 42 04040 403 321 377 121,017 Kit No. 10A - 02525 - - 76 - Kit No. 10B 00 100 100 998 99,800 Kit No. 11A - 01313 25 12 518 6,216 Kit No. 11B - 03838 50 12 3,769 45,228 Kit No. 12 - 01414 50 36 1,081 38,916 334 199714885 4,199 2,980 1,782,069
8. Dignity Kits8
9. Medical Equipment & Supplies9
10. Life-saving MCH Medicines10ChildrenWomenPneumoniaDiarrhoea MalariaNeonatal sepsis HIVVitamin A deficiency Palliative care and pain VaccinesPPHMaternal sepsis Safe abortion, incomplete abortion & miscarriage Pre-eclampsia/ EclampsiaSexually transmitted infections Management of preterm labour Maternal HIV/AIDS and malaria Prevention of tetanus in mother and newborn Contraception
11. WHO Priority Medicines11ChildrenPriority conditionRecommended life-saving medicine(s)PneumoniaAmoxicillin, dispersible tablets; Ampicillin inj; Ceftriaxone inj; Gentamicin inj; OxygenDiarrhoeaOral rehydration salts (ORS); Zinc dispersible tablet MalariaArtemisinin combination therapy Artesunate rectal and injection Neonatal sepsis Ampicillin inj; Ceftriaxone inj; Gentamicin inj; Procaine benzylpenicillin inj HIVStandard regimen for first‐line antiretroviral treatmentVitamin A deficiencyVitamin A capsulePalliative care & painMorphine granules, inj, or oral liquidVaccinesNational EPI guidelines
12. WHO Priority Medicines12WomenPriority conditionRecommended life-saving medicinesPost-partum haemorrhageOxytocin injMisoprostol tablet Severe pre-eclampsia & eclampsiaMagnesium sulfate inj; Calcium gluconate inj Severe hypertensionHydralazine inj & tablet; Methyldopa tablet Maternal sepsisAmpicillin inj; Gentamicin inj; Metronidazole inj CACMisoprostol tablet; Mifepristone + misoprostol tablet STIsAzithromycin capsule; Cefixime capsule; Benzathine benzylpenicillin inj Management of preterm labour Nifedipine immediate release capsule; Dexamethasone or Betamethasone inj Maternal HIV/AIDS and malaria National guidelines Prevention of tetanus in mother and newbornTetanus vaccineContraceptionOral contraceptives; Injectable contraceptives; Implantable contraceptives; Intrauterine devices & barrier methods of contraception
13. Life-saving MCH Medicines13TargetProducts (13)Reproductive HealthFemale condomContraceptive implants Emergency contraceptionMaternal HealthOxytocinMisoprostolMagnesium sulfate Child HealthAmoxicillin Oral Rehydration Salt (ORS)Zinc sulfateNewborn HealthInjectable antibiotics Antenatal corticosteroids Chlorhexidine Resuscitation devices
14. UNFPA Procurement Processes
15. How to Access CommoditiesMOUIPA or MOU (Adapt template + Project profile)MOH routeRequisitionComplete requisition/ order formGet approval & submit to warehouse DeliveryPartner to pick from warehouseTransportation to the field (pre-positioning)ReportingMonthly reports: SRH/ FP/ MCH indicators, consumption, stock balancesRH Working GroupMonthly attendance15
16. ContraceptivesReproductive health kitsMedical equipment itemsAccessRH Online Product CatalogPharmaceutical products4018400+50+Midwifery and Fistula repair kits4Now including census products!
17. AccessRH Key BenefitsPublic procurement principlesOpen international bidding processProduct & pricing information onlineTransparent ProcessCompetitive, pre-negotiated pricesProcurement, contracting and QA expertise Value for MoneyCost savingsStringent UNFPA / WHO QA practicesPre-qualified suppliers and productsQuality Assured ProductsPre-shipment inspection, sampling and testingTrusted Partner in RH SuppliesLong-term agreements with suppliersReduced lead time for in-stock productsTime SavingsOnline planning tools and simplified ordering processComprehensive audit rating = Satisfactory
18. All Information Available at MyAccessRH.orgProduct CatalogRHInterchangeHow to orderBudget plannerQuality assurance policyList of quality assured suppliersInformation ServicesProcurement ServicesCustomized artwork guidelinesLead time calculatorProcurement e-learning
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20. ChallengesMoneyStorageLast Mile DeliveryRational UseLMISHR – Supply chain
21. Making It WorkFinancing – No Products, No ProgramProcurement – Mix RH kits & non-kitsWarehousing/ Storage – Buffer stocks/ Pre-positioningCapacity building – supply chain managementCoordination/ Communication – National & CountyIntegration – RH commodities as part of MOH-EMPLMIS – Consumption data / Early warning signalsAccountability – Medicines = Money21
22. Over the last 5 years AccessRH delivered over 185 million condoms from inventory